Trends of Medicare reimbursement rates for gender affirmation procedures.

Autor:	Siotos C; Division of Plastic and Reconstructive Surgery, Rush University Medical Center, Chicago, IL 60607, United States., Underhill JM; Division of Plastic and Reconstructive Surgery, Rush University Medical Center, Chicago, IL 60607, United States., Sykes J; Division of Plastic and Reconstructive Surgery, Temple University Hospital, Philadelphia, PA 19140, United States., Jones KB; Division of Plastic and Reconstructive Surgery, Rush University Medical Center, Chicago, IL 60607, United States., Schechter L; Division of Plastic and Reconstructive Surgery, Rush University Medical Center, Chicago, IL 60607, United States., Dorafshar AH; Division of Plastic and Reconstructive Surgery, Rush University Medical Center, Chicago, IL 60607, United States., Hamidian Jahromi A; Division of Plastic and Reconstructive Surgery, Temple University Hospital, Philadelphia, PA 19140, United States.
Jazyk:	angličtina
Zdroj:	The journal of sexual medicine [J Sex Med] 2024 Jan 30; Vol. 21 (2), pp. 181-191.
DOI:	10.1093/jsxmed/qdad160
Abstrakt:	Background: While nearly 1 in 5 Americans receives health insurance coverage through Medicare, literature suggests that Medicare reimbursement is lagging behind inflation for many plastic surgery procedures. Aim: This article evaluates trends in Medicare reimbursement for gender affirmation procedures. Methods: The most common gender affirmation procedures performed at an urban academic medical center were identified in this cross-sectional study (level 4 evidence). Five nongender surgery codes were evaluated for reference. A standardized formula utilizing relative value units (RVUs) was used to calculate monetary data. Differences in reimbursement between 2014 and 2021 were calculated for each procedure. Outcome: The main outcome was inflation-adjusted difference of charges from 2014 to 2021. Results: Between 2014 and 2021, Medicare reimbursement for gender affirmation procedures had an inflation-unadjusted average change of -0.09% (vs +5.63% for the selected nongender codes) and an inflation-adjusted change of -10.03% (vs -5.54% for the selected nongender codes). Trends in reimbursement varied by category of gender-affirming procedure. The overall average compound annual growth rate had a change of -0.99% (vs -0.53% for the selected nongender codes). The average changes in work, facility, and malpractice RVUs were -1.05%, +9.52%, and -0.93%, respectively. Clinical Implications: Gender surgeons and patients should be aware that the decrease in reimbursement may affect access to gender-affirming care. Strengths and Limitations: Our study is one of the first evaluating the reimbursement rates associated with the full spectrum of gender affirmation surgery. However, our study is limited by its cross-sectional nature. Conclusions: From 2014 to 2021, Medicare reimbursement for gender affirmation procedures lagged inflation. (© The Author(s) 2023. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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